Abstract: The global malaria epidemic is still severe. Because of simple procedures, rapid detection and accuracy results, rapid diagnostic test (RDT) has become the most important and the most widely used diagnostic tool for malaria prevention and control. However, deletions in the RDT target Plasmodium falciparum histidine⁃rich protein 2/3 (Pfhrp2/3) genes may cause false⁃negative results of RDT, which has been included as one of the four biological threats to global malaria elimination. This article reviews the applications of RDT in the global malaria diagnosis, analyzes the threats and challenges caused by Pfhrp2/3 gene deletion, proposes methods for monitoring Pfhrp2/3 gene deletion, and summarizes the causes and countermeasures of negative RDT detections, so as to provide insights into consolidation of malaria elimination achievements in China and contributions to global malaria elimination.

Key words: Malaria, Elimination, Rapid diagnostic test, Histidine?rich protein, Gene deletion

摘要： 全球疟疾流行依然严峻，疟疾快速诊断试纸条（rapid diagnostic test，RDT）操作简便、检测快速、结果准确，已成为当前疟疾防控中最重要和最广泛使用的诊断工具。但RDT靶标恶性疟原虫富组氨酸蛋白2/3（Plasmodium falciparum histidine⁃rich protein 2/3, Pfhrp2/3）基因缺失可导致RDT产生假阴性检测结果，被WHO列为全球消除疟疾的四大生物学挑战之一。本文通过回顾RDT在全球疟疾诊断中的应用，分析Pfhrp2/3基因缺失带来的威胁与挑战、提出Pfhrp2/3基因缺失的监测方法、总结RDT检测阴性的原因与对策，为巩固我国消除疟疾成果、助力全球消除疟疾提供参考。

关键词: 疟疾, 消除, 快速诊断试纸条, 富组氨酸蛋白, 基因缺失